Stigma Increases HIV Infections Among Young Black Gay Men

It's one thing to read that the rate of HIV infection continues to be alarmingly high among African-American young men. It's quite another to give it a name and a place.

Unlike many young men of color who have sex with men, Detroit native Dwayne Washington has always identified as gay. Even so, he told EDGE, when Washington, then 21, found out that he was HIV-positive seven years ago, "I didn't know at the time what HIV was, and I never had any sex education classes in high school. I never had sex education anywhere. I was just winging it."

He was only tested because he had to see a doctor about symptoms that he suspected were indicative of syphilis. At the time, he was trying to establish a monogamous relationship with another man. He looks back on a youth he now considers reckless and all of the times when he had unprotected sex. That said, he added, the man who he says he contracted the virus from was even more reckless.

Black youth represent half of all new HIV infections among young people aged 13 to 29, the Center for Disease Control has reported. Black heterosexual women are severely impacted, but young black gay and bisexual men comprise more than three-quarters of new infections among young black men. Although only 13 percent of the U.S. population is African American, black men account for more new infections than any other identifiable group of men who have sex with men. According to the CDC, HIV incidence among young black gay men is roughly twice that of their white and Hispanic counterparts age 13 to 29.

Washington heard the news with what some may see as surprising equanimity. "OK, it is what it is," he told himself, "I think because it didn't really change anything for me. I wasn't getting sick, and I felt the same."

He shared his diagnosis with only one other person, a close female friend, who was more emotional about it than he was. He would only begin to tell others years later; until this day, he has tried to keep the news from his family.

(Source:Thinkstock by Getty Images)

Church & Family Still Deny Reality of HIV

Unfortunately, that is a situation not uncommon for men like Washington. Many black families and churches still shy away from any discussion of homosexuality. Despite its pervasive effect on their community, many blacks continue to associate HIV with being gay. "When I came out, it was treated like a joke and never taken seriously," Washington said. "The way they treated me when I came out, I didn’t want my HIV status to be treated the same way."

If anything made HIV "normal" for Washington, it was the fact that most of his inner circle were also positive. "I found out that 99 percent of the people that I had sex with were HIV-positive," he said, "So it was no big deal."

Only when he moved to Chicago a year after his diagnosis did Washington seek medical advice about going on meds -- and then half a year after that, solely on the advice of a friend. But in Chicago, too, his acquaintances were nearly all HIV-positive. He continued to be blasé about the situation.

"I didn’t have to discuss it with anyone," he said. "It was very casual and nobody talked about it. To my knowledge, everyone I had sex with had HIV or knew that I was HIV-positive," which is why he continued to have unprotected sex.

He didn’t seek a support system and complains that groups at various clinics didn’t really cater to his needs. "Something just wasn’t right with those groups," he said.

Unlike many who remain isolated and in deep denial, however, Washington did something about it. In 2012, he created an online support group on Facebook. At first only friends from Chicago and Detroit whom he specifically invited to join, the private group soon grew to the point that there are now 500 members. He is currently working on a book that he hopes will inspire others like him who are living with HIV. He also hopes the book will counter stigmatization in the black community.

Michael S. Hinson Jr., the director of policy and programs for the Center of Black Equity (formerly known as the International Federation of Black Prides, Inc.) in Washington, D.C., agrees that too many support groups, agencies and organizations working with minorities and HIV prevention are falling short.

Since, as Hinson pointed out, one in four black gay men are infected with HIV, their acquaintances or sex partners are very likely to be HIV positive. "The question," Hinson asked, "becomes, What do you do with it, and what are you prepared to do?"

In the face of stigmatization by family and church, poverty, drug use, overall lack of education, and President George Bush’s legacy of abstinence-only HIV education in public schools to the exclusion of instruction on safe sex, groups catering to black gay men need to develop what Hinson called a holistic approach to HIV education. "It has to be done holistically because of the number of different issues facing them," he said.

(Source:Thinkstock by Getty Images)

Equally Isolated in the Country or Big City

Hinson pointed to the South, where a raft of societal ills and a lack of funds have pushed HIV to the sidelines. "You have poverty, drug use, socioeconomic issues, education," he noted. "With all those issues, it’s easy to see how some areas may not make HIV a priority. Some places in the South don’t even have billboards, so you don’t even have a billboard to put a message on.

"The HIV service program," he continued, "is 50 miles from your house and there is no public transportation -- and you have to get there somehow. I can’t ask anyone to take me because I’m afraid of the stigma. All those things must be taken into consideration." Not that the big urban centers up North don’t deal with the same issues, he hastened to add.

Hinson would take issue with a recent article in Out magazine that some young urban black men, if not actually soliciting HIV, look at it as the only way out of a life of grinding poverty. "You never hear a person say they want to be HIV-positive," he said. "More experimenting happens in the younger groups."

As for Washington, he has taken a long look around him and sees young black men making the same mistakes, with the same devil-may-care attitude. "If I could turn back the hands of time, I would have more education," he said. "But I’m not saying that would have made any difference because I like what I like."

"I just feel like a lot of people in this next generation use sex as a tool, a bargaining tool to get money, and they don’t necessarily care about the ramifications," Washington added. "I think they know what the risks are, but they blatantly don’t care."

February 7 is National Black HIV/AIDS Awareness Day, and in cities across the country, organizations are offering discussions, luncheons, HIV testing and other educational efforts aimed at lowering rates of HIV transmission in communities of color.

African-American women have the highest obesity rate of any group of Americans. Four out of five black women have a body mass index above 25 percent, the threshold for being overweight or obese, according to the Centers for Disease Control and Prevention.

In this edition of Ask a Doc, sexual health expert and physician in residence at Roman Health Dr. Michael Reitano shines the spotlight on how sexual health studies handle erectile dysfunction in same sex relationships-emphasis on relationships.